Provider Demographics
NPI:1942333026
Name:CAMP, DIANA KAY (CMT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:KAY
Last Name:CAMP
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:LA VETA
Mailing Address - State:CO
Mailing Address - Zip Code:81055-0093
Mailing Address - Country:US
Mailing Address - Phone:719-742-5565
Mailing Address - Fax:
Practice Address - Street 1:124 N MAIN
Practice Address - Street 2:
Practice Address - City:LAVETA
Practice Address - State:CO
Practice Address - Zip Code:81055
Practice Address - Country:US
Practice Address - Phone:719-742-5565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist